Document Detail

Increased sensitivity of electrophysiological study by isoproterenol infusion in unexplained syncope.
MedLine Citation:
PMID:  16321671     Owner:  NLM     Status:  MEDLINE    
The purpose of the study was to evaluate the interests of electrophysiologic study (EPS) after infusion of isoproterenol in patients with syncope and negative EPS in control state. METHODS: 1350 patients were consecutively admitted for syncope and EPS. Patients were included if they had no history of tachycardia, a normal Holter monitoring, a negative EPS in control state. EPS was repeated after infusion of 2-4 mug/kg of isoproterenol. RESULTS: 256 patients, 35 with exercise-related syncope and 105 with heart disease (HD), were recruited. After isoproterenol, an arrhythmia was identified as the sign associated with syncope in 102 patients (40%): SVT in 32 patients, VT in 36 patients, infrahisian 2nd or 3rd degree AV block in three patients and vasovagal reaction in 31 patients. Arrhythmias were more frequent in patients with HD (50/105) than in those without HD (52/151) (p<0.05); SVT tended to be more frequent in patients without HD (n=23) than in those with HD (n=9) (p<0.1); VT was more frequent in patients with HD (n=26) than in those without HD (n=10) (p<0.001). There was no relationship between a positive isoproterenol testing and occurrence of syncope at exercise (19/35 vs 81/221) (p<0.1). CONCLUSION: isoproterenol infusion increased the sensitivity of EPS in patients with syncope, related or not to exercise, and with negative study in control state, but principally in those with HD. However, SVT was diagnosed in patients without HD and EPS associated with isoproterenol infusion remained an important and rapid tool to establish this diagnosis.
Beatrice Brembilla-Perrot; Iyad Muhanna; Olivier Marçon; Batric Popovic; Arnaud Terrier de la Chaise; Pierre Louis; Marius Andronache; Marc Nippert; Olivier Claudon; Daniel Beurrier; Pierre Houriez; Hadj Belhakem
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of cardiology     Volume:  106     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2005-12-02     Completed Date:  2006-03-16     Revised Date:  2006-07-12    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  82-7     Citation Subset:  IM    
CHU de Brabois, Cardiologie, 54500 Vandoeuvre Les Nancy, France.
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MeSH Terms
Cardiotonic Agents / diagnostic use*
Electrophysiologic Techniques, Cardiac
Isoproterenol / diagnostic use*
Middle Aged
Sensitivity and Specificity
Syncope / diagnosis*,  physiopathology
Reg. No./Substance:
0/Cardiotonic Agents; 7683-59-2/Isoproterenol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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